Glaucoma/kala Motia- A silent and irreversible cause of blindness.

Glaucoma( Kala Motia) is the third leading cause of PERMANENT  and irresistible blindness in India, a disease unknown to many. About 1.2 crore people are affected annually in India.

Anyone can develop glaucoma but it’s more common in people over the age of 45. Children can get rare form of early onset glaucoma.

Getting a thorough dilated eye (via drugs) examination is the only way to catch glaucoma early.

Person with glaucoma will slowly lose their PERIPHERAL(side) vision and later CENTRAL (straight-ahead) vision is also lost.

Glaucoma damages the eye’s optic nerve which is a data cable coming out of the back of your eye and going to brain, thus disrupting the wires of optic nerve and disrupting flow of visual signals.

Once damage is done, vision loss cannot be restored.

Eye pressure is a major risk factor for glaucoma but not every person with increased eye pressure will develop glaucoma and Glaucoma can develop WITHOUT INCREASED eye pressure.

The proven treatment is to lower eye pressure via drugs/surgery to increase drainage of eye fluid or promote lesser production of eye fluid through drugs.

Lack of AWARENESS and LACK of SYMPTOM prevent people from getting glaucoma diagnosed early resulting in permanent blindness.

Dr Arjun Kumar Singh.
Avadh Eye Hospital, kankarbagh, Patna

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Ref- Indian glaucoma society

Eye Surgeon verses Optometrist- An unfair but essential comparison

Do you think the corporate spectacle shops ( including online ones)  & the optometrist at the corner of your road can diagnose and  treat you for your eye vision problem completely & accurately? After reading this post , you may need a change in your opinion.

One should be aware of signs of simple condition like myopia which are on a regular basis now a days by optometrist who calculates eye power.

  • Signs of near sightedness( myopia)- include, genetic predisposition if mothers and fathers are myopic, squinting, eye strain , feeling fatigued when driving or playing sports, malignant myopia where the vision loss can be rapid due to elongation of eyeball and is irreversible. Similarly there are various reasons for presbyopia, astigmatism.
  • The people with high myopia may suffer from Retinal detachment( laser is required for its correction) .
  • An optometrist is incompetent/not trained to look behind your lens. If he misses the retinal detachment and does not refer you to the eye surgeon, you will have to face the consequence.
  • In case of compound power, it is purely the competence of optometrist which will help in determining the power of lens. Many cases are coming up with wrong power calculation. It is advisable to consult an eye surgeon before going to a spectacle shop. Once the eye power has increased, it cannot be lowered without surgical intervention.
  •  It’s for the patient to decide whether he considers optometrist ( guys with degree in power calculation sitting in corporate and local eye shops, authorized to calculate eye power , competent enough to diagnose even these condition completely and afford to miss the retinal detachment and silent diseases like glaucoma or other associated eye pathology if they are present in eyes.
  • The patient’s power will increase through incorrect or incomplete diagnosis and harm his eyes.It’s your eyes , always consult an experienced eye surgeon before you go to any spectacle shop to buy your spectacles
  • There are silent and irreversible disease in family like glaucoma or kala motia which has a family history.
  • It is the duty of the doctor to ask history of such disease. Can you expect your local optician to ask such history? If he misses your glaucoma by not checking your eye pressure, you vision loss is irreversible.
  • The guy sitting in spectacle shop may sell you a branded  eyeglasses, give a very good deal and pamper you with snacks but what purpose it serves if the some part of your diagnosis is missed and causes irreversible loss of vision.
  • The optometrist is trained just in power calculation and dispensing of contact lenses. He is not trained to diagnose and treat any eye disease, look behind the lens through indirect opthalmoscope, use instruments like slit lamp.  He is incompetent to treat any eye disease like amblyopia or lazy eye. 
  • If he is giving medicine/drugs along with dispensing of spectacles , he is most probably committing a crime.
  • If you are going to optometrist first , it purely depends on his training and expertise whether he is able to suspect any associated pathology or not and refers you the eye surgeon and if he misses it or makes a wrong diagnosis, the loss is yours and only yours.
  • Lastly the optometrist will be never held responsible for wrong diagnosis. The doctor’s prescription caries a legal value and he will always advice in patient’s best interest.


Dr Arjun Kumar Singh

Avadh Eye Hospital, Patna


Planning for a cataract surgery in the family.Here are the must know and eye opening facts.

  • Common public is often sensitized by marketing executives to go for expensive eye lens for cataract surgery. Patients are lured to buy them for better vision . The lens MRP is 2 to 10 times the actual cost price. In name of free surgery patient is implanted a extremely low cost lens usually in charitable hospital. Lens is major factor which determines the cost and quality of surgical outcome and its price varies from Rs 500 to Rs 50000. However the type of lens should be customized to patient’s needs.
  • Another important factor is the expertise and experience of surgeon which is a major determinant of surgical outcome.
  • Charitable surgery by charitable hospital exists only where external implants are put in patients like eye, orthopedics etc and not in neurosurgery, ENT, general surgery, plastic surgery where mostly removal of the diseased part is done or modification of the surgical site is done. Charitable surgery by eye hospital is supported by vision 2020 of WHO.
  • The chances of eye infection increases if your surgery is listed lower down as compared to the first surgery on that day. Patients are advised to have their surgery listed as first or second case. With improving standards of OT and sterilization of instruments, the infection rates have decreased drastically but why take a chance.
  • Once there is an eye infection following cataract surgery, there is little hope of return of vision.
  • Patient is advised to choose his doctor and institution or hospital where he is getting the surgery done based on its doctor’s past reputation and the reputation of institution and should not get lured by free surgery camps and  unless he can’t afford to pay, since infection following cataract surgery needs at least 48 hours to manifest and its risk is extremely high in eye camps despite taking various measures due to unavoidable circumstances. Its your eyes after all!

                                        Patients should be aware of various types of IOL ((intraocular lenses) and its benefit over other lenses.  Cataract is also called ‘Motiyabin” in Hindi. Phacoemusification also called Phaco is the most common procedure done for its removal.

  • Here is a complete summary of type of lens implanted in cataract surgery and it’s pros and cons.

Monofocal lens- Here you will need glasses to look at the near objects after cataract surgery.

  • Accommodating monofocal lenses(Crysta lens)-A newer option, accommodating monofocal lenses, can shift from near to far vision in response to movements of the ciliary muscles in your eye, similar to the natural lens in a younger eye. These lenses offer excellent distance and middle vision, but they aren’t as reliable for near vision. Eye exercises can help you get used to them, but about half of people who receive them still end up needing reading glasses.
  • Toric lenses-These specialized monofocal lenses are designed for people with astigmatism. Toric lenses offer focused vision at a single distance and correct your astigmatism, so you might not need distance glasses after surgery.
  • Multifocal lenses-Like the bifocal or progressive lenses used in glasses, multifocal lenses have different areas designed for distance, intermediate, and near vision. The brain and eye figure out which part of the lens to use. The main drawback of multifocal lenses is they can distort bright light, creating more glare and halos at night.
  • Aspheric lens- Designed to improve contrast sensitivity and visual clarity under certain circumstances.
  • Monovision-This implant technique uses a monofocal lens with a different power in each eye so that you don’t have to use glasses for most of your daily activities. Your dominant eye is generally set for distance, and the other eye is set for near. Many people successfully use monovision with contact lens. Successful monovision requires cataract surgery to each eye.

One should remember that all that glitter is not gold in this commercialized world

  • Consult online/book physical appointment/take a second opinion or get contact details on  Stay anywhere in India , get honest and unbiased advice from us.


Dr Arjun Kumar Singh

Avadh Eye Hospital, Patna

Avadh Eye Hospital, Patna


Smartphone & Kids- Its not so smart for your kid’s eyes

Parents using smartphone may not experience much harm but your little ones are prone to serious consequences which you should be aware of.

  • Many eye surgeons believe that heavy computer( smartphone is even worse) use among children puts them at risk for early MYOPIA. Haven’t you seen today’s generation wearing more specs than ever before? Remember Lasik lasers for eyeglass removal is not as safe as it is made out to be.
  • Symptoms of DRY EYE disease were more common in children who spent more time on smartphones and less time outdoors than other young people. 
  • Staring at smartphones, computers and other screens has been linked to reduced blinking, which can lead to faster evaporation of the tear film and increase the risk of dry-eye disease, it’s a most common problem among IT professionals and now it’s  affecting children who are  just 10 years old.Smartphones also have a short watching distance due to their small screens that can tire the eyes.Can you afford burning eyes in your child where the tear glands have stopped tear production and needs lifelong lubricating eye drops?
  • Excessive smartphone use may lead to a rare form of strabismus, or “CROSSED EYES,” known as acute acquired comitant esotropia. Strabismus most often appears in infancy, but sometimes kids develop it suddenly.
  • Computer use demands fine motor skills from young eyes that are not well developed. Only when the visual system matures is a child better able to handle the stress of a computer on that system. Remember brain and eyes are linked , a poor reception by eyes leads to poor mental development

What to do now?

1) Push your child to play outdoor sports( must)

2) Before starting school eyes must be checked by an experienced doctor, serious eye problem if found early can save your child vision.

3) Please limit the smartphone exposure of your child. Their eyes are not same as yours. Their brain development is also incomplete and eyes play a major role in development of brain.

4)Encourage kids to take 20-second breaks from the computer every 20 minutes to minimize the development of eye focusing problems and eye irritation. (Some eye doctors call this the “20-20 rule.”)

5)Check the ergonomics of the workstation. For young and small children, make sure the computer workstation is adjusted to their body size. The recommended distance between the monitor and the eye for children is 18 to 28 inches. Viewing the computer screen closer than 18 inches can strain the eyes.  For smartphone, the answer is complete avoidance. Smartphone is causing much more harm than desktop due to its small screen size.


Dr Arjun Kumar Singh

Avadh Eye Hospital, Patna


Doctor has experience of 38 yrs, more than 50000 eye surgeries and 10000 Phaco surgeries for cataract. Doctor has pioneered Phaco surgery for cataract in undivided Bihar and was second person to do so in East India in 1995

Get personalized advice online/take second opinion/book physical appointment online/read  complete detail of doctor on . Find us on google and google maps

Getting Lasik laser for eyeglass removal- Always take a second opinion

Considering LASIK lasers( for EYE GLASS REMOVAL) for their eye glass removal. One must read this as it has some serious implications/complications if done in haste.

  • There are lot of benefits by being myopic (eye power  less than -3 D) and disadvantages in going for LASIK laser in young age with low eye power.
  • You may never need glasses after 40 years ( presbyopia) of age for reading if you use glasses or contact lens now instead of getting operated by LASIK Lasers( for powers less than – 3D and around -3D).
  • After lasers you may need eye glasses so going for laser may keep you free from glass for roughly 15 to 20 years only. The myopia can come back even after LASIK surgery.
  • There are variety of complications with LASIK lasers like GLARE ,HALO and problem in COLOUR contrast, DRY eyes, problem in NIGHT vision, serious complications like CORNEAL ECTASIA ( may need corneal transplant) .
  • Although advancement in lasers has minimized these issues still one should refrain from getting lasik done for low eye power since the percentage of side effects are highly underplayed.
  • The disadvantages according to my experience outweighs the benefits in young  age for those with low myopia (-3D) and considering the risks involved and amount of side effects associated with it which are highly under reported by the doctor.
  • LASIK operated emmetropic ( having normal eye power) are not allowed in AIRFORCE , RAILWAYS and ARMY.
  • If you are young and advised for LASIK in haste without giving due consideration about thickness of cornea ,it MAY result in complications after 5 years and can affect rest of your life.

If you are having high eye power ( more than -3D) then there are various issue which should be taken in consideration .

  • First and foremost , the corneal(outer membrane for eye) thickness must be measured by pachymetry. Indians have a thinner cornea around 400 to 500 micron as compared to western population ( around 600 micron).
  • The critical thickness of cornea must be above 300 micron even after LASIK lasers to avoid/minimize future complications. Since laser burns the cornea, for removing every 1D of eye power, there is a reduction in 35 micron thickness in cornea. 
  • Indians with average thickness of cornea being 400 to 500 micron can only go upto 35*5= 175 micron reduction to ensure that their corneal thickness remains above critical thickness of 300 micron, so patients are advised to take a INDEPENDENT opinion from a EXPERIENCED  OPHTHALMOLOGIST preferably before going for LASIK laser to avoid life long complications.
  • One can use contact lenses which have become quite advanced with time, if one does not want glasses. All that glitters is not gold and not every side effect can be predicted.
  • Ref http:/
  • Doctor has done 50000 eye surgeries and has pioneered Phaco surgery in undivided Bihar in 1995 and was the second person to start phaco for cataract surgery in Eastern India and has cumulative experience of 34 years in eye care.


Dr Arjun Kumar Singh

Avadh Eye Hospital, Patna

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